Interview with Jodi Hajicek, Turtle Mountain Band of Chippewa Indians
At the Turtle Mountain Band of Chippewa Indians, their opioid-related work is divided between work funded by the CDC, and work funded by other resources such as Health Resources and Services Administration (HRSA), and SAMHSA.
Their current CDC funding is used to host and provide training and educational events on cultural connectedness activities; this includes presenters on herbal medicines, traditional healing, historical trauma, as well as hands-on craft creation (ribbon shirts and skirts, medicinal earrings, moccasin making). Jodi expresses, “Attendees will get the teachings along with the crafts and learn how healing is connected to the crafts, and learn about culture is prevention; for example, learn why someone would wear a ribbon skirt. Community mentors are brought into the events to share their beliefs and how they create these crafts, so the community is sharing and learning from each other.”
The goal of these events is to provide community members with an opportunity to reconnect to culture. “Culture is prevention, it’s the healing of facing traumas, realizing why we are who we are, being proud of things we are still able to do such as cultural connectedness programming. People want to teach the youth too. There is interest in these types of cultural connectedness programming.”
Part of “facing traumas” is the acknowledgement of how historical trauma impacts the present. “It’s why we are who we are, it’s not our fault. We want to help Tribal community members understand this, and understand where we want to be, through reclaiming identity and healing.”
Jodi started working at TMBCI in February 2024, and previously worked for public health at the state and county level. “This is a dream job, now being able to incorporate the culture, working directly with the people where I live. Now I get to work for my people where I grew up. She knew her name was tied to prevention services in the area, as people reached out to her wanting Narcan training when she started. Jodi stated, “We will include Narcan training and supplies in our Year 2 funding application, and more of the craft sessions, including expanding to drum making. A lot of these things are important because we’re meeting our community where they’re at now.”
These services operate out of the 5th Generation Healing Center, “a tribally run Alcohol and Other Drug service program which serves the Turtle Mountain Chippewa Indian Reservation with a continuum of care in the prevention, intervention, and treatment of the disease of alcoholism and other drug abuse for individuals, families, and communities.” Other CDC-funded projects include general disease prevention and a mobile health unit (“to try to provide services to rural areas to reduce barrier of transportation”), which carries Narcan.
One of TMBCI’s non-CDC-funded projects involves building their public health workforce capacity. At Turtle Mountain Community College, they have a 9-month public health leadership certificate, with 15 graduated students so far, in addition to an Associate of Applied Science degree in Public Health Leadership. The public health department has grown in the last 3-4 years, with a lot of capacity building that began during COVID: “We brought on a state health director, Dr. Terry Dwelle, and a Tribal epidemiologist; we think we’re a rare case to be able to have our own Tribal Epidemiologist. Through CDC Foundation, we also brought on 5 field staff.” These staff assist in disease testing (COVID, RSV, flu, monkeypox) and communications (“someone to share the status of health issues”). TMBCI also has a small grant to partner with local educational systems (Turtle Mountain Community School System, St John School District, Ojibwa Indian School, and Dunseith Day School) to emphasize the importance of public health in schools. Another school-based partnership involved bringing in the North Dakota Public Health Training Network which was provided to school administrators and staff.
“We’re trying to secure and strengthen partnerships, that in itself can be a component for overdose prevention. In the community, many rely on the county public health department, and Turtle Mountain Public Health is trying to increase visibility and show the community what resources are available; we are there for them.”
Transportation issues remain a barrier to public health access due to TMBCI’s rural location near the Canadian border. “We hear a lot that we’re doing a lot of healing. Our Tribal community is very large (80% of county is Native American people), but there’s a large population that hasn’t been reached. How do we reach the people, how do you get those resources to the people, to the housing sites where people are?” The rural location also struggles with lack of cell phone service to call in for support.
Jodi and colleagues also acknowledge insufficient necessary resources to support overdose prevention, like behavioral health services, treatment and recovery centers—this creates a backlog of referrals, where even if they refer to the behavioral health branch, there’s no availability for appointments.” “This creates a Revolving Door Effect: people come in and don’t address the underlying issue. For example, they’ve been to treatment several times, but never addressed ADHD or specific traumas.” They’re excited their next round of funding will include a Licensed Clinical Social Worker to focus on and treat mental health concerns, as well as address trauma.
Another source of excitement within the public health department is upcoming tobacco control work for North Dakota. “We’re offering tobacco training from Mayo Clinic in October for staff at the Public Health Department and Recovery Center. It will help educate the staff on addiction, especially the peer support specialists. This is important, as 40% of respondents in our 2022 Community Health Assessment indicated smoking.”
“With public health, I want to save the world. I have to remind myself it’s about reducing rates. We want to heal everyone, but we have to start by reducing rates.”